Description We are offering a role as a Collections Specialist in Costa Mesa, California. This role is crucial within our team, primarily focusing on account resolution and payment processing. The successful candidate will be working with insurance companies, government payors, and patients to ensure the timely resolution of payments and accounts. This role offers a contract employment opportunity and is ideal for those with a strong understanding of the Revenue Cycle processes and thorough knowledge of managed care contracts, current payor rates, and federal and state requirements.

Responsibilities:

• Serve as the primary account representative for the organization in dealing with insurance companies, government payors, and/or patients for payment resolution.

• Evaluate claims at the contract rate with the use of the contract management tool for proper pricing.

• Initiate the initial appeal for underpayments observing all timely requirements to secure reimbursement.

• Review and complete payor and/or patient correspondence in a timely manner.

• Escalate to the payor and/or patient accounts that need to be appealed due to improper billing, coding, and/or underpayments.

• Report new/unknown billing edits to the supervisor for review and resolution.

• Demonstrate a strong understanding of the Revenue Cycle processes, from Patient Access (authorizations admissions) through Patient Financial Services (billing & collections), including procedures and policies.

• Interpret Explanation of Benefits (EOBs) and Electronic Admittance Advices (ERAs) to ensure proper payment as well as assist and educate patients and colleagues with understanding of benefit plans.

• Establish a payment arrangement when patients are unable to pay in full at the time payment is due.

• Process bankruptcy and deceased patient accounts when necessary. Requirements • Proficient in Customer Service skills with a focus on maintaining a positive relationship with clients.

• Ability to handle Documentation tasks efficiently and accurately.

• Familiarity with Procedures and Policies related to collections and payment processing.

• Experience in Cash Activity management that involves tracking, reporting, and rectifying discrepancies.

• Skilled in reviewing and analyzing financial documents and transactions.

• Knowledge of Medical Coverage policies and procedures.

• Ability to understand and implement Pricing strategies in relation to collections.

• Familiarity with Benefit Functions and Billing processes.

• Experience in Collection Processes and its related Correspondence.

• Understanding of Claim Administration procedures.

• Basic understanding of Clinical Trial Operations and Consumer Electronics.

• Proficient in Coding techniques and Authorizations related to collections.

• Ability to use Methodology for problem-solving and decision-making.

• Experience working with Insurance Companies, dealing with Reimbursements, Medicare processes, and Appeals.

• Ability to manage Patient Account effectively.

Robert Half is the world’s first and largest specialized talent solutions firm that connects highly qualified job seekers to opportunities at great companies. We offer contract, temporary and permanent placement solutions for finance and accounting, technology, marketing and creative, legal, and administrative and customer support roles.

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All applicants applying for U.S. job openings must be legally authorized to work in the United States. Benefits are available to contract/temporary professionals, including medical, vision, dental, and life and disability insurance. Hired contract/temporary professionals are also eligible to enroll in our company 401(k) plan. Visit roberthalf.gobenefits.net for more information.

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